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Endarterectomy for Stenosis of 70% or Greater With Symptoms

Research clearly shows that carotid endarterectomy has more benefits
than treatment with medicine if you have symptoms and 70% or greater stenosis (narrowing). Symptoms include a previous TIA or mild stroke. footnote 1

Most people in this group can significantly reduce their risk of
stroke by having an endarterectomy if they are healthy enough to
have surgery and they have a highly skilled surgeon who has a low
complication rate. A low complication rate means the surgeon has had only a small number
of patients who, because of the surgery, have a stroke or other
complications.

Research suggests that the surgeon should have a complication rate of no more than 6% for this procedure to be
considered beneficial for his or her patients. If the rate is higher than 6%, the risks outweigh the benefits. This means that you are
more likely to have complications from the surgery than to benefit from
long-term reduction in your risk of stroke.footnote 2

To find your surgeon's complication rate, check with his or her
office, the hospital where the surgery will be done, and your state's
medical association. Access to this information may vary by state.

Another thing to think about is the hospital itself. In general, larger
hospitals and regional medical centers have staffs that do more carotid endarterectomies than those in smaller hospitals. Check to
see how many of these procedures are done in your hospital each year.

Kernan WN, et al. (2014). Guidelines for the prevention of stroke in patients with stroke and transient ischemic attack: A guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke, 45(7): 2160–2236. DOI: 10.1161/STR.0000000000000024. Accessed July 22, 2014.

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